Area pharmacists wary about becoming frontline in dispensing COVID antiviral

Published: Jul. 19, 2022 at 5:51 PM EDT
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BURLINGTON, Vt. (WCAX) - Pharmacists can now prescribe the COVID antiviral medication Paxlovid without a doctor’s approval. The move is intended to get the highly effective treatment to more people, faster. But staffing and reimbursement issues are creating barriers to putting the plan into practice in this area.

The Food and Drug Administration earlier this month said pharmacists can begin screening patients to see if they are eligible for Paxlovid and then prescribe the medication.

Paxlovid is typically prescribed when a patient is COVID positive, above 50 years old, or has risk factors such as asthma. It also needs to be taken within five days of the onset of symptoms. That’s partly why federal officials are allowing pharmacists to prescribe and dispense it without a doctor’s prescription.

But pharmacists we spoke to say they don’t want to be the first line of defense in place of a regular doctor. “It’s there as a backstop. It’s great as the alternative to no care, but it should never take the place of the primary care office and primary care provider,” said Gabe Gilman with the Vermont Board of Pharmacy.

That’s because pharmacists in the region say they are already stretched thin. “I think there are very few pharmacies that would be able to absorb this workload without the reimbursement that would enable them to bring in the additional staff to cover these services,” said Lauren Bode with the Vermont Pharmacists Association.

Paxlovid is an extremely complex drug. It requires time to adequately prescribe because pharmacists need to have a full patient history. “There is a little more pressure on the patient to have that material so the pharmacist knows if your liver and kidneys work well because those are also important in prescribing,” said Vt. Health Commissioner Dr. Mark Levine.

“This is a medication that has a lot of drug interactions. It takes about 15 to 30 minutes per prescription to do the clinical work necessary to ensure that it is appropriately prescribed,” Bode said.

Currently, pharmacies in Vermont are not reimbursed for the time and decision-making in the process of whether or not to prescribe a medication like Paxlovid.

Because it is so new, many Vermont pharmacies are not prescribing Paxlovid yet on their own.

CVS officials say they are looking at the federal guidance to figure out what to do.

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